POS0597-HPR HEALTH LITERACY IN INDIVIDUALS WITH KNEE PAIN - A MIXED METHOD STUDY
Authors: C. Sylwander, A. Klopstad Wahl, M. Andersson, E. Haglund, I. Larsson
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Health literacy (HL) is the ability to access, understand, appraise, and apply health information [1]. A low level of HL is associated with worse pain problems, poorer self-care, and an obstacle for health-promoting interventions among individuals with chronic pain and radiographic knee osteoarthritis (rKOA). <h3>Objectives</h3> To examine 1) the level of HL and associations with chronic pain, rKOA, lifestyle habits and health status, and 2) to explore the individuals' experiences of HL. <h3>Methods</h3> The study has a convergent parallel mixed-method design, including 221 individuals with knee pain (148 women, mean age 56±8 years). A purposeful sample of 19 individuals (11 women, 8 men) was selected for interviews. Quantitative data were general HL (GHL) assessed by HLS-EU-Q16, electronic HL (eHL) by eHEALS, pain distribution by a pain figure, rKOA by x-rays, lifestyle habits, and health status via SF-36. GHL and eHL were merged into one variable, "HL", where sufficient HL was defined as having a sufficient level of GHL or eHL. Statistical analyses were Chi<sup>2</sup> test, Mann-Whitney U-test, univariate and multivariate logistic regressions. Qualitative data consisted of individual semi-structured interviews that were analysed using manifest qualitative content analysis with an abductive approach based on the HLS-EU health literacy matrix [2]. <h3>Results</h3> Of the 221 participants, 29% reported limited HL. Those with limited HL reported lower education, less usability and importance of the internet for accessing health information and making informed health-related decisions, and lower general health (GH) compared to the group with sufficient HL (data not shown). Higher education, CRP, a healthier diet, and minor alcohol consumption were associated with sufficient HL (Table 1). Only higher education and GH remained associated when adding GH to the multivariate analysis. Individuals' experiences of HL were described as 1) Searching for information influences the decision-making process by being an active searcher or passive receiver; 2) Processing of information influences the decision-making process by having light, moderate or high processing of the information; and 3) Taking a stand on the information influences the decision-making process based on trust and/or motivation (Figure 1). <h3>Conclusion</h3> Limited HL was found in one-third of the individuals with knee pain. CRP and healthy lifestyle habits were associated with sufficient HL, but higher education and health status had the strongest association. The search, level of process and standpoint on the health information influenced the decision on action. More research on HL is needed to gain knowledge of how to develop health promotion to prevent worsening pain problems in individuals with knee pain. <h3>References</h3> [1]Sørensen et al., <i>Health literacy and public health: A systematic review and integration of definitions and models.</i> BMC Public Health 2012, 12(1):80. [2]Sørensen et al., <i>Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q).</i> BMC public health 2013, 13(1):948. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.